Rates of depression, anxiety, and stress in King Abdulaziz University freshmen, Jeddah, Saudi Arabia: a cross-sectional study


  • Sulhi A. Alfakeh Department of Internal Medicine, Faculty of Medicine, King Abdulaziz University, Jeddah, Saudi Arabia.
  • Khaled Mesfer Alghamdi Faculty of Medicine, King Abdulaziz University, Jeddah, Saudi Arabia.
  • Rawan Mostafa Hilal Faculty of Medicine, King Abdulaziz University, Jeddah, Saudi Arabia.
  • Marwa Mohamed Abdelmoaty Faculty of Medicine, King Abdulaziz University, Jeddah, Saudi Arabia.




Depression, Anxiety, Stress, Saudi Arabia, Students


Objective: This cross-sectional study aimed to determine the rates of depression, anxiety, and stress among first-year university students in Saudi Arabia.

Method: We distributed an online survey through to 861 first-year students, aged 17-25, at King Abdulaziz University. The survey used a validated Arabic short version of the Depression Anxiety and Stress Scales, and sociodemographic factors.

Results: The prevalence of depression, anxiety, and stress was 80.4%, 71.8%, and 69.3%, respectively. A plurality showed extremely severe depression and anxiety, and severe stress symptoms. The frequency of exercise was inversely related to depression, anxiety, and stress. A total of 8.2% of students had visited a psychiatrist at some point in their lives, and 40.5% of students had suicidal thoughts.

Conclusion: Programs to identify students suffering from mental illness and offer adequate care and support are essential.


GBD 2017 Disease and Injury Incidence and Prevalence Collaborators. Global, regional, and national incidence, prevalence, and years lived with disability for 354 diseases and injuries for 195 countries and territories, 1990–2017: A systematic analysis for the Global Burden of Disease Study 2017. Lancet, 2018;392(10159):1789–1858. https://doi.org/10.1016/S0140-6736(18)32279-7

American Psychiatric Association. Anxiety. 2019. https://www.apa.org/topics/anxiety/index

American Psychiatric Association. Major depressive disorder and the “bereavement exclusion.” American Psychiatric Association. 2013.

Grøtan, K, Sund, ER, Bjerkeset, O. Mental health, academic self-efficacy and study progress among college students – the SHoT study, Norway. Front Psychol, 2019;10:Article 45. https://doi.org/10.3389/fpsyg.2019.00045

Ibrahim, AK, Kelly, SJ, Adams, CE, Glazebrook, C. A systematic review of studies of depression prevalence in university students. J Psychiat Res, 2013;47(3):391–400. https://doi.org/10.1016/j.jpsychires.2012.11.015

Stallman, HM. Prevalence of psychological distress in university students: Implications for service delivery. Austral Family Phys, 2008;37(8):673–677.

Shamsuddin, K, Fadzil, F, Ismail, WSW, Shah, SA, Omar, K, Muhammad, NA, et al. Correlates of depression, anxiety and stress among Malaysian university students. Asian J Psychiat, 2013;6(4), 318–323. https://doi.org/10.1016/j.ajp.2013.01.014

Silverstein, ST, Kritz-Silverstein, D. A longitudinal study of stress in first-year dental students. J Dental Educ, 2010;74(8):836–848.

Rice, KG, Leever, BA, Christopher, J, Porter, JD. Perfectionism, stress, and social (dis)connection: A short-term study of hopelessness, depression, and academic adjustment among honors students. J Counsel Psychol, 2006;53(4):524–534. https://doi.org/10.1037/0022-0167.53.4.524

Kessler, RC, Foster, CL, Saunders, WB, Stang, PE. Social consequences of psychiatric disorders I: Educational attainment. Am J Psychiatry,1995;152(7):1026–1032. https://doi.org/10.1176/ajp.152.7.1026

Bayram, N, Bilgel, N. The prevalence and socio-demographic correlations of depression, anxiety and stress among a group of university students. Social Psychiat Psychiatr Epidemiol, 2008;43(8):667–672. https://doi.org/10.1007/s00127-008-0345-x

Adewuya, AO, Ola, BA, Afolabi, OO. Validity of the patient health questionnaire (PHQ-9) as a screening tool for depression amongst Nigerian university students. J Affect Disord, 2006;96(1-2):89–93. https://doi.org/10.1016/j.jad.2006.05.021

Aboalshamat, K, Hou, X-Y, Strodl, E. Psychological well-being status among medical and dental students in Makkah, Saudi Arabia: A cross-sectional study. Med Teacher, 2015;37(sup1):S75–S81. https://doi.org/10.3109/0142159X.2015.1006612

Alhabeeb, AA, Alasmari, SS, Alduraihem, RA, Qureshi, NA. Mental Health Awareness Phone Polling Survey: Focus on community knowledge, attitude and practice, Saudi Arabia. Int Neuropsych Dis J, 2019:1–14. https://doi.org/10.9734/indj/2019/v13i230106

Druss, BG. Mental health quality improvement goes global. World Psychiat, 2018;17(1):44–45. https://doi.org/10.1002/wps.20487

Gilbert, P, McEwan, K, Irons, C, Bhundia, R, Christie, R, Broomhead, C, et al. Self-harm in a mixed clinical population: The roles of self-criticism, shame, and social rank. Brit J Clin Psychol, 2010;49(4):563–576. https://doi.org/10.1348/014466509X479771

Srivastava, K, Chatterjee, K, Bhat, PS. Mental health awareness: The Indian scenario. Indust Psychiatry J, 2016;25(2), 131–134. https://doi.org/10.4103/ipj.ipj_45_17

Raosoft. Sample Size Calculator. Raosoft, Inc. 2004. http://www.raosoft.com/ samplesize.html.

Moussa, MT, Lovibond, P, Laube, R, Megahead, HA. Psychometric properties of an Arabic version of the Depression Anxiety Stress Scales (DASS). Res Social Work Pract, 2017;27(3):375–386. https://doi.org/10.1177/1049731516662916

Beiter, R, Nash, R, McCrady, M, Rhoades, D, Linscomb, M, Clarahan, M, et al. The prevalence and correlates of depression, anxiety, and stress in a sample of college students. J Affect Disord, 2015;173:90–96. https://doi.org/10.1016/j.jad.2014.10.054

Abdallah, AR, Gabr, HM. Depression, anxiety and stress among first year medical students in an Egyptian public university. Int Res J Med Med Sci, 2014;2(1):11–19.

Gao, W, Ping, S, Liu, X. Gender differences in depression, anxiety, and stress among college students: a longitudinal study from China. J Affect Disord, 2020;263:292–300. https://doi.org/10.1016/j.jad.2019.11.121

Byeon, H. Association among smoking, depression, and anxiety: Findings from a representative sample of Korean adolescents. PeerJ, 2015;3(10):e1288. https://doi.org/10.7717/peerj.1288

Khaled, SM, Bulloch, A, Exner, DV, Patten, SB. Cigarette smoking, stages of change, and major depression in the Canadian population. Can J Psychiatry, 2009;54(3), 204–208. https://doi.org/10.1177/070674370905400309

Kulsoom, B, Afsar, NA. Stress, anxiety, and depression among medical students in a multiethnic setting. Neuropsychiat Dis Treatment, 2015;11:1713–1722. https://doi.org/10.2147/NDT.S83577

Martini, S, Wagner, FA, Anthony, JC. The association of tobacco smoking and depression in adolescence: evidence from the United States. Subst Use Misuse, 2002;37(14):1853–1867. https://doi.org/10.1081/JA-120014087

Al Saadi, T, Zaher Addeen, S, Turk, T, Abbas, F, Alkhatib, M. Psychological distress among medical students in conflicts: a cross-sectional study from Syria. BMC Med Educ, 2017;17(1):173. https://doi.org/10.1186/s12909-017-1012-2

Callaghan, P. Exercise: a neglected intervention in mental health care? J Psychiat Mental Health Nurs, 2004;11(4):476–483. https://doi.org/10.1111/j.1365-2850.2004.00751.x

Lawlor, DA, Hopker, SW. The effectiveness of exercise as an intervention in the management of depression: systematic review and meta-regression analysis of randomised controlled trials. BMJ, 2001;322(7289):763–767. https://doi.org/10.1136/bmj.322.7289.763

Auerbach, RP, Mortier, P, Bruffaerts, R, Alonso, J, Benjet, C, Cuijpers, P, et al., WHO WMH-ICS Collaborators. WHO World Mental Health Surveys International College Student Project: Prevalence and distribution of mental disorders. J Abnorm Psychol, 2018;127(7):623–638. https://doi.org/10.1037/abn0000362

Al-Subaie, AS, Al-Habeeb, A, Altwaijri, YA. Overview of the Saudi National Mental Health Survey. Int J Methods Psychiat Res, 2020;29(3):e1835. https://doi.org/10.1002/mpr.1835

Alosaimi, FD, Alshehri, Y, Alfraih, I, Alghamdi, A, Aldahash, S, Alkhuzayem, H, et al. The prevalence of psychiatric disorders among visitors to faith healers in Saudi Arabia. Pak J Med Sci, 2014;30(5):1077–1082. https://doi.org/10.12669/pjms.305.5434

Ebert, DD, Mortier, P, Kaehlke, F, Bruffaerts, R, Baumeister, H, Auerbach, RP, et al. Barriers of mental health treatment utilization among first-year college students: First cross-national results from the WHO World Mental Health International College Student Initiative. Int J Methods Psychiatric Res, 2019;28(2):1–14. https://doi.org/10.1002/mpr.1782

Mahmoud, MA. Knowledge and awareness regarding mental health and barriers to seeking psychiatric consultation in Saudi Arabia. Asian J Pharm Res Health Care, 2019;10(4):109–116. https://doi.org/10.18311/ajprhc/2018/23359

Corrigan, PW, Druss, BG, Perlick, DA. The impact of mental illness stigma on seeking and participating in mental health care. Psychol Sci Public Interest, 2014;15(2):37–70. https://doi.org/10.1177/1529100614531398

World Health Organization. Suicide. 2019. https://www.who.int/news-room/fact-sheets/detail/suicide

Ahmed, AE, Alaqeel, M, Alasmari, NA, Jradi, H, Otaibi, HA, Abbas, et al. Risk assessment of repeated suicide attempts among youth in Saudi Arabia. Risk Manag Healthcare Policy, 2020;13:1633–1638. https://doi.org/10.2147/RMHP.S245175

Ejjennane, FE. Religion and psychological well-being: Does Islam offer protection against suicide? [Master’s thesis]. Harvard Extension School. 2019. https://nrs.harvard.edu/URN-3:HUL.INSTREPOS:37365390

Duffy, A, Keown-Stoneman, C, Goodday, S, Horrocks, J, Lowe, M, King, et al. Predictors of mental health and academic outcomes in first-year university students: Identifying prevention and early-intervention targets. BJPsych Open, 2020;6(3):e46. https://doi.org/10.1192/bjo.2020.24

China, T, Ratanasiripong, P, Toyama, S, Nann, N. The first-year experience: Mental health of university students in Okinawa, Germany, and Thailand. 2020

Kessler, RC, Walters, EE, Forthofer, MS. The social consequences of psychiatric disorders, III: Probability of marital stability. Am J Psychiatry, 1998;155(8), 1092–1096. https://doi.org/10.1176/ajp.155.8.1092




How to Cite

Alfakeh, S. A., Alghamdi, K. M., Hilal, R. M., & Abdelmoaty, M. M. (2021). Rates of depression, anxiety, and stress in King Abdulaziz University freshmen, Jeddah, Saudi Arabia: a cross-sectional study. Journal of Contemporary Medical Sciences, 7(2), 116–121. https://doi.org/10.22317/jcms.v7i2.962